摘要
目的构建社区医生处方行为中使用基本药物意向的结构方程模型,分析国家基本药物制度的实施对社区医生处方行为的影响。方法采用知-信-行(KAP)问卷调查广州市444名社区医生开具处方时对基本药物的相关知识、态度和行为意向。对调查数据进行结构方程模型拟合、参数检验,通过评价修正确定最终模型。结果在444名被调查对象中,有290人(占65.32%)认为自己很熟悉国家基本药物制度;有410名社区医生(占92.34%)参加过1次以上基本药物相关的培训或学习;有89.19%(396/444)的社区医生认为"非常愿意"和"愿意"使用基本药物。结构方程模型分析显示:结构方程模型拟合较好,正向影响基本药物的处方行为意向的因素为基本药物培训、基本药物认知、基本药物认同度和积极的外界因素;而基本药物的处方行为意向的阻碍因素为基本药物种类少、短缺感知和基本药物可替代性感知。结论广州市社区医生处方行为中开具基本药物的意向较高,社区医生对基本药物的培训、认知、态度、基本药物制度自身的状况是其主要影响因素。建议继续加强对医生群体的宣传和培训工作,加强管理和进一步增强社区医生临床合理应用基本药物的意识和能力。积极开展对社区居民的宣传教育,使其树立科学、经济的用药观念,进一步完善基本药物制度配套措施,营造积极的处方环境。
Objective To build a structural equation model describing the community doctors＇ behaviour in prescription to apply essential drugs,and analyze the influence of implementing national essential drug system on community doctors＇ behaviour of prescription.Methods The questionnaire survey on knowledge,attitude and practice（KAP） was conducted among 444 community doctors in Guangzhou City about their prescription of essential drugs.The collected primary data were estimated by maximum likelihood and parameter test,and a final structural equation model（SEM） was determined by comprehensive evaluation and necessary modification.Results Among the 444 participants there were 290（65.32%） who believed that they were very familial with the national essential drug system,and 410（92.34%） who participated in the training on the relative knowledge of essential drugs once or more.Some 89.19%（396/444） of them were very willing or willing to use essential drugs in their prescription.The analysis of structural equation model showed that the model was of good fitness,the positive factors influencing the prescription behaviour of using essential drugs were training on,cognition and recognition of the essential drugs,and active external factors;while the negative factors were less sorts of essential drugs,and apperception of shortage and substitutability of the essential drugs.Conclusion The intent of the community doctors＇ behaviour to prescribe the essential drugs is high in Guangzhou.And its main influencing factors are their training,cognition,attitude on the essential drugs,and the conditions of essential drug system.It is suggested to further strengthen the propaganda and training of national essential medicine system so as to establish a scientific and economic idea of medication and create a positive policy-environment for prescription.
出处
《中国全科医学》
CAS
CSCD
北大核心
2013年第22期2570-2573,2583,共5页
Chinese General Practice
关键词
基本药物制度
社区医生
处方行为
结构方程模型
Essential drug system
Community doctor
Prescribing behaviour
Structural equation model
作者简介
通讯作者：王家骥，510182广东省广州市，广州医科大学公共卫生学院；E—mail：wjiaji@163．com
